Konjac-Mannan and American Ginsing: Emerging Alternative Therapies for Type 2 Diabetes Mellitus

Konjac-Mannan and American Ginsing: Emerging Alternative Therapies for Type 2 Diabetes Mellitus

Vladimir Vuksan, PhD^,^,, John L. Sievenpiper, MSc^,^,, Zheng Xu, MD, MSc^,, Evelyn Y. Y. Wong, MSc^,, Alexandra L. Jenkins, RD^,, Uljana Beljan-Zdravkovic, MD, MSc^,, Lawrence A. Leiter, MD^,^,, Robert G. Josse, MBBS^,^, and Mark P. Stavro, MSc^,

Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, CANADA
Clinical Nutrition and Risk Factor Modification Centre (V.V., J.L.S., Z.X., E.Y.Y.W., U.B.Z., A.L.J., L.A.L., R.G.J., M.P.S.), St. Michael’s Hospital, Toronto, Ontario, CANADA
Division of Metabolism and Endocrinology (V.V., L.A.L., R.G.J.), St. Michael’s Hospital, Toronto, Ontario, CANADA

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Fig. 1. Postprandial glycemic responses to a 20 g oral glucose challenge done alone ( ${circ}$ ) or following 3 g of psyllium ( ${lozenge}$ ), xanthan ( ${square}$ ), or konjac mannan ( ${blacktriangleup}$ ) (A) and the calculated glycemic indexes of three fibers relative to oral glucose alone (B). GI was expressed as the area under the curve (AUC) for each fiber divided by the AUC for oral glucose alone multiplied by 100. Points or bars with different letters are significantly different (repeated measures ANOVA adjusted for multiple pairwise comparisons with the Newman Keuls procedure, p < 0.05). Statistics expressed for GI differences were done for the differences in the absolute AUC values. Data are mean ± SEM. Reference [26].

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Fig. 2. Percent change in (A) measures of glycemic control (fasting plasma glucose, plasma insulin, and serum fructosamine) and systolic blood pressure and (B) measures of serum cholesterol (total, LDL, total:HDL ratio, and apolipoprotein B-100 [Apo-B]) after 3-weeks of supplementation with either konjac mannan (KJM, ${blacksquare}$ ) or wheat bran (WB) control ( ${square}$ ) biscuits in 11 subjects with type 2 diabetes mellitus, hyperlipidemia, and hypertension receiving a metabolically controlled National Cholesterol Education Program (NCEP) step 2 diet. p-values are for a GLM ANCOVA, adjusted for repeated measures, starting value, randomization sequence, diet, age, and gender. Data are mean ± SEM. Reference [29].

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Fig. 3. Percent change in (A) measures of glycemic control (fasting plasma glucose, plasma insulin, and serum fructosamine) and systolic blood pressure and (B) measures of serum cholesterol (total, LDL, total:HDL ratio, and apolipoprotein B-100 [Apo-B]) after 3-weeks of supplementation with either konjac mannan (KJM, ${blacksquare}$ ) or wheat bran (WB) control ( ${square}$ ) biscuits in 11 subjects with the insulin resistance syndrome (IGT, dyslipidemia, central obesity, mild hypertension) receiving a metabolically controlled National Cholesterol Education Program (NCEP) step 2 diet. p-values are for GLM ANCOVA, adjusted for repeated measures, starting value, randomization sequence, diet, age, and gender. Data are mean ± SEM. Reference [30].

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Fig. 4. Comparison of the total and LDL cholesterol lowering ability of the 4 main dietary soluble fibers (psyllium, oats, guar gum, and pectin) versus KJM. Values for the 4 fibers are taken from the meta-analysis of Brown et al. [35] and values for KJM represent the mean reduction in cholesterol taken from the two studies by Vuksan et al. [29,30]. Data are presented as change in cholesterol (mmol/L) per gram of soluble fiber.

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Fig. 5. Incremental change and area under the curve (AUC) in plasma (A) glucose and (B) insulin following America ginseng (AG) taken 40 minutes before ( ${blacktriangleup}$ ) or together ( ${triangleup}$ ) with a 75 g oral glucose tolerance test (75 g-OGTT), or a 75 g-OGTT done alone ( ${circ}$ ) in 8 nondiabetic subjects. Points or bars with different letters are significantly different (repeated measures ANOVA adjusted for multiple pairwise comparisons with the Newman Keuls procedure, p < 0.05). Data are mean ± SEM. Reference [61].